Month: March 2012
Feet of Clay
It has been tough in Portland this year. The Trailblazers, our NBA, and only professional team, started out on a tear, then went right down the toilet. It is painful to see such promise dribbled away. Sigh. Why is elation always followed by disappointment? Everyone and everything has feet of clay. Except Cassius Marcellus. At the beginning of March the NEJM had...
Lying for the State
Quacks lie. In some ways, that’s what separates us from them. Real doctors are stuck with the messy truth: with bad news, with uncertain outcomes. It’s this reliance on the truth which gives us much of our credibility. Laws forcing doctors to lie to patients take me back to reading Kundera in the 80s; the hovering fear that everyday actions might bring...
Anti-anti-vax: Getting to the gist
I’m currently putting the finishing touches on a presentation for the The Ontario Public Health Convention next week, where I’ll be speaking, with occupational therapist Kim Hébert, about the anti-vaccine movement and social media (SM): how antivaccine advocates use it, and the challenges and opportunities for public health advocates. I’m pleased to see Seth Mnookin, author of The Panic Virus and someone...
A Universal Anti-Cancer Drug?
We frequently deal with fraud and quackery on this blog, because part of our mission is to inform the public about such things, and also they are great examples for explaining the difference between legitimate and dubious medical claims. It is always our goal not just to give a pronouncement about this or that therapy, but to work through the logic and...
CAM as a Dumping Ground
I know a woman who is a survivor of colorectal cancer. At one point, doctors had given up hope and put her in hospice, but she failed to die as predicted and was eventually discharged. She continues to suffer intractable symptoms of pain with alternating diarrhea and constipation. I don’t have access to her medical records, but she tells me her doctors...
The Species in the Feces: Probiotics and the Microbiome
I do not understand the interest many appear to have in their bowels and the movement there of. But then, I pay little attention to most of my body functions as long they are functioning within reasonable parameters, and as I get older the definition of reasonable is increasingly flexible. The elderly especially seem to obsess about their bowels. My theory is...
The CAM Docket: Boiron I
Author’s note: This will inaugurate a series of occasional posts observing the wheels of justice grind slowly over “CAM.” In a previous post, I posited that CAM practitioners might well subject themselves to liability for the tort of fraudulent misrepresentation. This misrepresentation could be based on both the lack of scientific evidence of effectiveness and the lack of scientific plausibility for their...
Disparities in Regional Health Care Costs
In 2009, during the “Obamacare” debate that was dominating the news, Atul Gawande wrote an article in the New Yorker that was widely praised and cited, including by president Obama himself. The article is a thought-provoking discussion of why some communities in the US have much higher health care costs than other regions. I took two main conclusions from the article. The...
How to Choose a Doctor
From an e-mail I received: As a proponent of SBM, and a someone who places a high value on reason, logic and evidence, I would like to find a physician who shares this mindset. He went on to ask how he could go about finding one. Another correspondent was referred to a surgeon by her primary physician, and the surgeon inspired confidence...